Epidemiological and molecular approaches for management of a measles outbreak in Liguria, Italy

Since March 2010 a measles outbreak has been occurred in Genoa, Liguria, an administrative Region in Northern Italy. Epi- demiological and molecular data on the outbreak, obtained from the passive mandatory notification system, the laboratory surveillance and an innovative syndrome surveillance system, were investigated. Overall 39 cases were reported in the urban area. Information about demography, vaccination status, hospitalization and geographic distribution of measles cases are available. 19 cases (48.7%) were laboratory-confirmed and were characterized by sequence analysis: 18 strains belonged to genotype D8, so identifying a new measles variant within the Liguria population. Adopted control measures seem to have limited viral circulation. The outbreak allowed to test the efficacy of the 3 surveillance systems active in Liguria, highlighting their advantages and some important limitations. More efforts are needed to collect and integrate any epidemiological and virological available data in order to better describe the local measles transmission dynamics

Knowledge and health care resource allocation: CME/CPD course guidelines-based efficacy.

BACKGROUND: Most health care systems consider continuing medical education a potential tool to improve quality of care and reduce disease management costs. Its efficacy in general practitioners needs to be further explored. OBJECTIVE: This study assesses the effectiveness of a one-year continuing medical education/continuing professional development course for general practitioners, regarding the improvement in knowledge of ARIA and GINA guidelines and compliance with them in asthma management. METHODS: Sixty general practitioners, covering 68,146 inhabitants, were randomly allocated to continuing medical education/continuing professional development (five residential events +four short distance-learning refresher courses over one year) or no training. Participants completed a questionnaire after each continuing medical education event; key questions were repeated at least twice. The Local Health Unit prescription database was used to verify prescription habits (diagnostic investigations and pharmacological therapy) and hospitalizations over one year before and after training. RESULTS: Fourteen general practitioners (46.7%) reached the cut-off of 50% attendance of the training courses. Knowledge improved significantly after training (p < 0.001, correct answers to key questions +13%). Training resulted in pharmaceutical cost containment (trained general practitioners +0.5% vs. controls +18.8%) and greater attention to diagnosis and monitoring (increase in spirometry +63.4%, p < 0.01). CONCLUSION: This study revealed an encouraging impact of educational events on improvement in general practitioner knowledge of guidelines and daily practice behavioral changes. Long-term studies of large populations are required to assess the effectiveness of education on the behavior of physicians in asthma management, and to establish the best format for educational events

Molecular identification and characterization of phytoplasmas infecting tomato in Oltrep&#242; pavese (northern Italy)

Tomato is affected by economically important phytoplasma diseases, such as stolbur, tomato big bud, tomato yellows, tomato witches\u2019-broom, tomato little leaf, and hojia de perejil. Such diseases, characterized by different geographic distribution patterns, have been associated with eight distinct \u2018Candidatus Phytoplasma\u2019 species in at least 30 countries throughout the world. In Italy, phytoplasma diseases of tomato were associated with infections by \u2018Ca. Phytoplasma solani\u2019, \u2018Ca. Phytoplasma asteris\u2019 and phytoplasmas of taxonomic groups 16SrIII and 16SrV. The present work aimed to investigate the aetiology of a disease affecting tomato in Oltrep\uf2 pavese (Lombardy, North Italy). During field surveys, carried out in a tomato plantation in August 2015, symptoms typically associated with phytoplasma infection (leaf purpling, witches\u2019-broom, flower and fruit alterations, and stunting) were observed on tomato plants. Based on 16S rRNA gene amplification and nucleotide sequence analyses, \u2018Ca. P. solani\u2019 was detected in 82% of symptomatic tomato plants and in bindweed plants. Molecular characterization based on tufB and stamp gene nucleotide sequence analyses revealed the presence of two 'Ca. P. solani' strain types: the type tufB-b/St5, identified respectively in 83% and 100% of tomato and bindweed infected plants, and the type tufB-a/St18 identified in 17% of tomato infected plants. These results suggest that \u2018Ca. P. solani\u2019 ecology in the examined agro-ecosystem is associated mainly with the bindweed-related host system. Based on such evidences, it should be interesting to evaluate the incidence dynamics of the disease and to investigate its epidemiology by tracing the movements of \u2018Ca. P. solani\u2019 throughout neighbouring fields

Molecular identification and characterization of phytoplasmas infecting tomato in North Italy

The present work aimed to investigate the aetiology of a disease affecting tomato in Oltrep\uf2 pavese (Lombardy, North Italy). During field surveys carried out in a tomato plantation in August 2015, symptoms typically associated with phytoplasma infection (leaf purpling, witches\u2019-broom, flower and fruit alterations, and stunting) were observed on tomato plants. Based on 16S rRNA gene amplification and nucleotide sequence analyses, \u2018Candidatus Phytoplasma solani\u2019 was detected in 82% of symptomatic tomato plants and in bindweed plants. Molecular characterization based on tufB and stamp gene nucleotide sequence analyses revealed the presence of two 'Ca. P. solani' strain types: the type tufB-b/St5, identified respectively in 83% and 100% of tomato and bindweed infected plants, and the type tufB-a/St18 identified in 17% of tomato infected plants. These results suggest that \u2018Ca. P. solani\u2019 ecology in the examined agro-ecosystem is associated mainly with the bindweed-related host system. Based on such evidences, it should be interesting to evaluate the incidence dynamics of the disease and to investigate its epidemiology by tracing the movements of \u2018Ca. P. solani\u2019 throughout neighbouring fields

Cardiovascular risk factors and metabolic control in type-2 diabetic subjects attending outpatient clinics in Italy : the SFIDA Study (Survey of risk Factors in Italian Diabetic subjects by AMD)

survey on major cardiovascular risk factor in type 2 diabetes : unsatisfactory control of recognition and treatmen

Phlobaphenes modify pericarp thickness in maize and accumulation of the fumonisin mycotoxins

Phlobaphenes are insoluble phenolic compounds which are accumulated in a limited number of tissues such as seed pericarp and cob glumes, conferring on them a typical red-brown pigmentation. These secondary metabolites, derived from 3-deoxy flavonoids, are thought to have an important role in plants\u2019 resistance against various pathogens, e.g. by reducing fungal infection, and also to have beneficial effects on human and animal health due to their high antioxidant power. The aim of this work was to determine the role of phlobaphenes in reducing mycotoxin contamination on maize kernels. We analysed the effect of the P1 (pericarp color 1) gene on phlobaphenes accumulation, pericarp thickness and fumonisins accumulation. Analysing fumonisins accumulation in different genetic backgrounds through three seasons, we found a clear decrease of these toxins through the three years (Wilcoxon test, Z = 2.2, p = 0.0277) in coloured lines compared with the isogenic non-coloured ones. The coloured lines, carrying P1 allele showed an increase of phlobaphenes (about 10\u201314 fold) with respect to colourless lines. Furthermore there was a correlation between phlobaphenes accumulation and pericarp thickness (R = 0.9318; p = 0.0067). Taken together, these results suggest that the P1 gene plays a central role in regulating phlobaphenes accumulation in maize kernels, and indirectly, also tackles mycotoxins accumulation. The development and cultivation of corn varieties rich in phlobaphenes could be a powerful tool to reduce the loss of both quality and yield due to mycotoxin contamination, increasing the safety and the quality of the maize product